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Stephan A. Schwartz

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Benjamin Franklin And a Modern American Portrait of Physical Health and Hunger

Posted: 11/01/10 05:48 PM ET

No founder had as detailed a plan, or worked more diligently to create the kind of country he had in mind than Benjamin Franklin. Two things he knew were important were healthcare and having enough to eat. He was a founder of the first hospital on these shores, and worked tirelessly to create opportunities so that more and more poor people could move up into the middle class, thus assuring hunger would not be an American issue. As we prepare to vote it is worth considering where we are on Franklin's goals on the eve of the election.

Physical Health

In 1950, before the inception of the present illness profit industry, the United States, compared with the world's other leading industrial nations was fifth with respect to female life expectancy at birth, surpassed only by Sweden, Norway, Australia, and the Netherlands.

In 2010 the United States position concerning female life expectancy had fallen to forty-sixth. And when both men and women were combined it fell to forty-ninth. Americans live 5.7 fewer years of "perfect health" -- a measure adjusted for time spent ill -- than the Japanese.

Is this the result of lack of spending on the part of the U.S.? Most emphatically it is not.

Health Policy expert Uwe E. Reinhardt, the James Madison Professor of Political Economy at Princeton University, headed a team that specifically considered this. They found,

...per capita health spending in the United States increased at nearly twice the rate in other wealthy nations between 1970 and 2002.6 As a result, the United States now spends well over twice the median expenditure of industrialized nations on health care, and far more than any other country as a percentage of its gross domestic product (GDP).

Peter A. Muennig, assistant professor of health policy and management at the Mailman School of Public Health, Columbia University, in New York City, and Sherry A. Glied professor of health policy and management at the Mailman School of Public Health, and currently on leave as Assistant Secretary for Planning and Evaluation at the Department of Health and Human Services (HHS), analysed Reinhardt's and many other studies, in a ground breaking exegetic survey of health care. They concluded that:

[N]one of the prevailing excuses for the poor performance of the US health care system are likely to be valid. On the spending side, we found that the unusually high medical spending is associated with worsening, rather than improving, fifteen-year survival in two groups for whom medical care is probably important.


We speculate that the nature of our health care system specifically, its reliance on unregulated fee-for-service and specialty care may explain both the increased spending and the relative deterioration in survival that we observed. If so, meaningful reform may not only save money over the long term, it may also save lives."

Hunger

It doesn't get much more basic that not having enough to eat. It is hard to think of America as a place where large numbers of people are facing hunger as a daily reality for themselves and, even worse, for their children. That happens in Africa, Haiti, someplace like that, but surely not here. You think not? Welcome to the American reality; millions of your fellow citizens routinely are forced to make life decisions based on whether they or their children will eat or go without in order pay for housing or medical bills. Today as we prepare to go the polls more than 1 in 8 Americans are now on food stamps, participation in the program has jumped about 70 percent from 26 million in May 2007, while the nation's unemployment rate rose from 4.3 percent to 9.2 percent through September of this year.

According to the largest study of domestic hunger ever done, Hunger in America 2010, a study which based on more than 61,000 interviews with clients and surveys of 37,000 feeding agencies "hunger is increasing at an alarming rate in the United States."

Feeding America, the largest foodbank system in the country has just reported it is "annually providing food to 37 million Americans, including 14 million children. This is an increase of 46 percent over 2006, when they were feeding 25 million Americans, including 9 million children, each year."

Here are more of their findings:

  • Feeding America's nationwide network is feeding 1 million more Americans each week than they did in 2006.
  • Thirty-six percent of the households they serve have at least one person working.
  • More than one-third of client households report having to choose between food and other basic necessities, such as rent, utilities and medical care.
  • The number of children the Feeding America network serves has increased by 50 percent since 2006.
  • They have seen a 64 percent increase in hunger in senior citizens' homes.

"Clearly, the economic recession, resulting in dramatically increasing unemployment nationwide, has driven unprecedented, sharp increases in the need for emergency food assistance and enrollment in federal nutrition programs," said Vicki Escarra, president and CEO of Feeding America, which operates some 200 food banks across the country.

"It is morally reprehensible that we live in the wealthiest nation in the world where one in six people are struggling to make choices between food and other basic necessities," Escarra said in a statement.

She added, "[t]hese are choices that no one should have to make, but particularly households with children. Insufficient nutrition has adverse effects on the physical, behavioral and mental health, and academic performance of children."

Feeding America's report is far from alone in reporting this food catastrophe.

The Food Research and Action Center reported that: "In July 2010, SNAP/Food Stamps participation set a new record: 41,836,330 persons, an increase of 560,873 individuals from July 2010, the prior record level, and an increase of more than 6.2 million people compared with the prior July."

Further that, nearly one in five of America's men, women, and children -- 18.5 percent -- reported that they had gone hungry in the past year. This was up from 16.3 per cent at the start of 2008. Even more alarmingly they said households where children were present were even likelier to experience hunger. Nearly 25 per cent of these families reported hunger in the past year.

Perhaps worst of all, the Feeding America study shows just how close to the edge the entire private food network has become. A point which is important since anti-government ideologues expect what social safety net there would be, if they had their way, would be private. Feeding America says 70 percent of their emergency food centers are reporting "one or more problems that threaten their ability to continue operating."

As the Pew Research Economic Mobility Project put it:

While belief in this American Dream remains a unifying tie for an increasingly diverse populace, it is showing signs of wear, with both public perceptions and concrete data suggesting that the nation is a less mobile society than once believed. This is not good: the inherent promise of America is undermined if economic status is, or is seen as, merely a game of chance, with some having the good fortune to live in the best of times and some the bad luck to live in the worst of times. That is not the America heralded in lore and experienced in reality by millions of our predecessors.

The world Franklin hoped for us.

Tuesday we are going to decide whether to further degrade the already frayed social network that has left us in this situation. Our problem is not debt or taxes; it is an unwillingness on the part of a significant fraction of our citizens to recognize that for a healthy democracy to thrive, a nation must have a healthy middle class. A healthy middle class can only be achieved when a compassionate social government network assures a minimum quality of life. No other institution can do this. To achieve it we need to develop policies based on data, not ideological mantras.

 

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04:43 PM on 11/05/2010
In addition to the above, Franklin realized that to make room warmer in the winter would make it possbible for colonists moving to the North. What more significant was that he understood the importance of virtual improvement . You can find more information on Franklin's efforts to build a new nation in North American from this link http://foundingfathersandchina.blogspot.com/
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HUFFPOST BLOGGER
Vicki B. Escarra
06:17 PM on 11/03/2010
Thank you, Stephen, for calling much-needed attention to the issue of hunger in America, which is far more prevalent than people realize. We hope that each of our newly elected officials recognizes the urgent need for well-funded food assistance programs, especially the child nutrition bill, and for the removal of barriers that prevent Americans from receiving the support they need to feed their families.
12:08 PM on 11/02/2010
If Benjamin Franklin was alive today - he would definitely be appalled at this U.S. scenario. So I ask, why are we in these dire straits???
1. We have driven corporations that create millions of jobs due to extreme taxation to other countries.
2. We have offed entitlements for so long that 50% of welfare recipients believe this to be a way of life,
not to mentions supporting millions of illegals.
3. State borders should be opened for healthy competition between insurance companies.
4. Healthcare for indigent, unemployeed, elderly, etc. should be addressed on a state level. There are
far too many penalties that need to be revised with state assisted healthcare.
5. As far as hunger, there are places people can go for free food and free meals.
There are far better ways to address our issues without nationalized healthcare. Americans have become fat and complacent due to entitlements. They want to pick and choose jobs they feel they would LIKE to do. Take away entitlements, you will see millions get off their duffs and work in positions they once felt they were to good. It's not up to the government to fix us - we the people need to fix US!!!!!
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HUFFPOST SUPER USER
veritas aequitas
12:26 PM on 11/02/2010
In the United States, isn’t the government the servant, not the ruler, of the citizens—isn’t the government an agent who must be paid for his services, and not a benefactor whose services are gratuitous, who dispenses something for nothing?

Why do Democrats act as if the government is the owner of the citizens’ income and can hold a blank check on our earnings?

The nature of the proper governmental services must be constitutionally defined and limited, leaving the government no power to enlarge the scope of its services at its own arbitrary discretion.
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HUFFPOST SUPER USER
veritas aequitas
12:36 PM on 11/02/2010
F&F
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HUFFPOST SUPER USER
veritas aequitas
11:54 AM on 11/02/2010
According to the American ideal–we are independent individuals with inalienable rights to support our own lives and happiness by our own efforts. That means taking responsibility for your own medical needs, just as you take responsibility for your grocery shopping and car payments. It means no one can claim that his need entitles him to your time, effort, or wealth.

Where is the willingness to defend this ideal by saying, “Your health is your responsibi­­and if you truly cannot afford the care you need, then you must ask for private charity–not pick your neighbor’s pocket to pay for it?"
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George Hanshaw
There are none so blind as those who will not see.
10:35 AM on 11/02/2010
"A healthy middle class can only be achieved when a compassionate social government network assures a minimum quality of life. No other institution can do this. To achieve it we need to develop policies based on data, not ideological mantras. "

What a crock of baloney. A healthy middle class comes from a stable business environment that lets entrepreneurs create. There is seldom anything creative about the federal government. Even when it tries, it takes huge amounts of money, and then has limited success (NASA, the Manhattan Project, the TVA).

Government is far more often an impediment to the middle class than it is an aid to them.
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HUFFPOST SUPER USER
Proud Progressive
danger may be real, but fear is a choice.
12:07 PM on 11/02/2010
Tell me, do you believe in the Easter Bunny and Santa Claus as well?
If there is one thing that history has demonstrated throughout the life of this country is that Business is not interested in the welfare of its (disposable) workers. Look at any of the African Nations for evidence of the efficiencty of small Government, and tell me which one you wouuld like to live in? If the answer is none, why would you want to turn the US into such a thing.
You people keep shouting the same thing, I guess in the hope that being loud is equal to being right.
Sad Sad Sad
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HUFFPOST SUPER USER
veritas aequitas
12:19 PM on 11/02/2010
"The two enemies of the people are criminals and government, so let us tie the second down with the chains of the Constitution so the second will not become the legalized version of the first."
Thomas Jefferson
12:12 PM on 11/02/2010
fanned and faved!!!
HUFFPOST PUNDIT
ThatsTheTheWayItIs
religion, ideology, partisanship are delusional
10:17 AM on 11/02/2010
THANK YOU for taking on the US for-profit medical industry, the biggest danger to the US.
Medicare causes most growth in deficit, particularly that drug industry subsidy called "Part D".

Before you THINK of cutting Social Security, eliminate Medicare. Start with Part D, work down the alphabet, then Medicare itself if necessary.

Social Security goes to us seniors, Medicare payments go to MDs, corporations, drug companies.

We seniors can decide whether spend the money on food and shelter, or on useless tests and drugs that do not keep us healthy or alive. You may disagree with that, it's your prerogative, spend the money on yourself if you believe it works.
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HUFFPOST SUPER USER
veritas aequitas
10:07 AM on 11/02/2010
"I am for doing good to the poor, but...I think the best way of doing good to the poor, is not making them easy in poverty, but leading or driving them out of it. I observed...that the more public provisions were made for the poor, the less they provided for themselves, and of course became poorer. And, on the contrary, the less was done for them, the more they did for themselves, and became richer."
B. Franklin
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HUFFPOST COMMUNITY MODERATOR
Gudrun
My micro-bio is empty
10:16 AM on 11/02/2010
I guess i can look forward to taking out my own appendix if I haven't met my deductible. Thanks.
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HUFFPOST SUPER USER
veritas aequitas
10:33 AM on 11/02/2010
Or you could pay for the services you need. Its a new concept for liberals; we call it personal responsibility.
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George Hanshaw
There are none so blind as those who will not see.
10:37 AM on 11/02/2010
"I guess i can look forward to taking out my own appendix if I haven't met my deductible. Thanks. "

You could anyway if the utilization review panel decids you don't have enough YPLL (years of productive life left) to justify it.

What? You haven't actually READ the Obamacare law EVEN YET?
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HUFFPOST SUPER USER
veritas aequitas
12:23 PM on 11/02/2010
According to the American ideal–we are independent individuals with inalienable rights to support our own lives and happiness by our own efforts. That means taking responsibility for your own medical needs, just as you take responsibility for your grocery shopping and car payments. It means no one can claim that his need entitles him to your time, effort, or wealth.

Where is the willingness to defend this ideal by saying, “Your health is your responsibi­­and if you truly cannot afford the care you need, then you must ask for private charity–not pick your neighbor’s pocket to pay for it?"
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HUFFPOST SUPER USER
veritas aequitas
12:35 PM on 11/02/2010
Sorry, it took an hour and a half for it to post above, so I thought it failed.
10:04 AM on 11/02/2010
The reason why health care reform was greatly watered down and why even those meager efforts are in jeopardy of being defunded is because the far right in this country has been pushing a mindset that any sacrifice, no matter how small, for the common good is an assault on their personal freedom. That message has been ingrained into the political class now that few even question it. Jimmy Carter was the last president who told the American people they might have to sacrifice to get through a recession and he was drummed out of office. Since then, no president has dared suggest such a thing, especially the republicans.

Remember after 9/11, when Bush was acted what the average American could do to help fight the terrorists? His response wasn't to give blood or volunteer to help veterans, or even cut back on gas consumption. It was to go shopping, to go to Disney World. His press secretary said it was "an American way of life" to burn as much petroleum as possible. That's the modern American idea of a "sacrifice": consume more to keep the machinery going.

Sacrifice instead has been equated with letting others freeload on your hard-earned dime. Today, we have republicans saying that the only reason why people are unemployed is that the meager unemployment insurance is "too good" to motivate them to find work.

I shudder to think how this generation would have reacted to FDR's calls for sacrifice to win WW II.
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thereisonlyoneparty
more amazing than you
10:21 AM on 11/02/2010
"The reason why health care reform was greatly watered down and why even those meager efforts are in jeopardy of being defunded is because the far right in this country has been pushing a mindset that any sacrifice, no matter how small, for the common good is an assault on their personal freedom."

The rights of the individual tend to trump those of society as the individual has no obligation to assist society in anyway. No one has an obligation to anyone else.

Regarding the 9/11 thing: the damage of 9.11 should never be measured in people. People do not matter. It needs to be measured in regard to financial/economic damage. A few thousand people can die without a lot of problems, but when their deaths cause billions of dollars in losses for the economy (they stopped flying plane, several prime developments were destroyed, the government overreacted and wasted loads of money, etc) it becomes a problem.
10:27 AM on 11/02/2010
Wow. Someone has read way too much Ayn Rand.
01:17 PM on 11/02/2010
You've turned it on its head. The right doesn't denigrate sacrifice as an assault on liberty. The right is on fire over the fact that every assault on liberty is marketed to us as a necessary sacrifice. And that these sacrifices are forced on us by law. We have no issue with sacrificing where we deem it necessary and prudent: but FORCE us to do anything and we have a serious issue with that.
02:51 PM on 11/02/2010
Every tax is by definition a sacrifice that is forced on you by law for the common. Which brings us to the central whine of the modern tea party movement. The old tea party cried, "No taxation without representation". The new tea party just says "no taxation, period". They want their fire, police, and military services. They just don't want to have to pay for it.
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HUFFPOST SUPER USER
Lisa Shields
Poet & Advocate For Special Needs Children
08:33 AM on 11/02/2010
"Health spending" no doubt includes the cost of health insurance.

I married in 1987. At the time, the cost for our "small family" was 87 dollars a month...office visits were a co-pay of 5 dollars. Prescriptions were still more or less affordable---but they were covered too.

Fast forward to today...still a small family... totaling three. WEEKLY insurance cost is 125 dollars, with a 3K a year deductible, then a 20 percent co-pay. Prescriptions are now tiered, and if you actually use the drug your doctor prescribes, the cost is 75 dollars each. Our healthcare costs for the last three years have exceeded our mortgage, with tax and insurance included.

So please...apples to apples. "Health care" costs sky rocketed in the last two decades, forcing consumers to pay far more...for far less.
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HUFFPOST SUPER USER
ZiloRS
11:24 AM on 11/02/2010
Yep. And ironically, the Republicans will defend it to the end despite it being a bloated business that works worst than the government.
01:19 PM on 11/02/2010
And NOBODY, right or left, wants to speak directly and without falsification to the root of that issue: why does setting a broken leg in 2010 cost so much more than in 1987.

Simple question. Answer it in 4 sentences or less and then get rid of THAT problem and everyone will be better off.
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HUFFPOST SUPER USER
Lisa Shields
Poet & Advocate For Special Needs Children
02:29 PM on 11/02/2010
Four sentences or less?

1. People but health insurance "just in case" something serious happens...but health insurance USED to cover almost everything.

2. Because people are terrified of not being able to take care of themselves, or their families, they have gone along with the price increases. because a free market doesn't actually exist.

3. Medical providers have raised their rate, while insurance companies have been allowed to pull the "usual and customary" scam (which NO ONE actually charges.) in what they will pay, usually shafting the consumer in the process.

4. PACS and Special Interest groups have lobbied both in individual states, and the federal government to obtain special legislation that protects them from paying claims, or suing if they fail to do so, as breech of contract.

Am I close?
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straightuptalker
What ever happened to common sense?
05:19 AM on 11/02/2010
By the "middle-class" do you mean the blue-collar workers that were the backbone of this country and its economy, once upon a time? But thanks to our government's decision to open the flood gates in reverse, the majority of our plants, factories and consumer goods are made in Communist China, boosting them to the level of the world's no. 1 importer, while many Americans left jobless must juggle between food on the table or pay the bills. And, while our major retailers, once based here in the U.S. jumped ship to go overseas for cheap labor and bigger profits, slamming their doors to Americans and their families. For any American to go hungry is unconscienable in this day and age. Unfortunately, we're quick to respond to third world countries facing the same crisis, but too busy to take care of our own. Hell, we don't even take care of our Military Veterans properly, and apparently, cannot even lay them to rest with dignity in the correct burial plot, considering the insensitive boobs we've got running Arlington Cemetery. We've got incompetent maroons running every aspect in government, bailed-out bank execs thumbing their noses at taxpayers whom provided the "rescue", CEO's resigning with obscene compensation packages, the filthy rich getting richer...and Americans are going hungry...what's happened to us?
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Inkosi
The gods themselves rage against stupidity
09:38 AM on 11/02/2010
F&F straightuptalker. Well said. I could not agree with you more.
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thereisonlyoneparty
more amazing than you
10:24 AM on 11/02/2010
The majority of our goods are made in places where labor is cheap. That is the best way for our society to prosper. Why should Americans waste their time making plastic trinkets? America was at one point about being innovative. That is really falling away now.

But there might be hope. As the US turns into Mexico or China (10 years ago China) or India then more developed societies--like now China and the EU and sort-of-now-sort-of-near-future India--will exploit unskilled uneducated Americans as a cheap labor source.
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11:38 AM on 11/02/2010
We were always told that we would handle high tech manufacturing and design while the underdeveloped world would take care of menial low tech. I'm not sure whether that mindset better embodies hubris or racism. The Indians, Chinese, et al are just as intelligent as us and quickly realized that they could have both high and low tech manufacture and design. Meanwhile, we are converting real assets into debt in order to fill our homes with stuff designed and built overseas which further impoverishes us and enriches them. Who turned out to be smarter after all?
01:27 PM on 11/02/2010
I think you have a false picture. You've got sound reasoning on a false assumption. Your premise, unstated, is that all American workers/citizens are generically the same and that generically they are capable of the highest-value labor. This is not true. The gap between the smartest/most motivated among and the (pardon me) dumbest/laziest among us is quite extreme. Further, it is simply unreasonable for us to expect that dumb/lazy will leave and go where the "plastic trinket" jobs are. Won't happen. So the the top 2/3 of the motivation/ability have to deal with the presence of the bottom third.

There are only two ways this flies. One way is welfare, and we are now living in the time of "having run out of other people's money". The other way is to have an employment sector where the stupid and lazy can provide value: cheap trinkets. And you what? There is something deeply wrong with being lazy, but there is absolutetly nothing wrong with being stupid. You can't help stupid. It's like ugly. You shouldn't denigrate or make fun of it because the guy can't help it. Stupid or not, the guy's gotta eat and understands the dignity of work versus the indignity of welfare.

A fix for this: local content rules. If you want to sell in America, some portion of every piece of the value chain of that product must be made in America. That includes engineering, raw materials, the whole gamut.
HUFFPOST SUPER USER
rucognizant
05:12 AM on 11/02/2010
Oh yes..............my ancestor Dr. John Bard ( Bard College) who lived at Hyde Park, ( now the Nat. historic Park Vanderbuilt Mansion) worked with his friend, Franklin to create that hospital ( as well as Columbia University)
The DNA has remained intact for 3 centuries........with that clarity of vision I have seen this disaster building for 30 years (or more )
Watch this You Tube today! STUNNING -
‘I REMEMBER, SO I’M VOTING, AND NOT REPUBLICAN.’

http://www.youtube.com/watch?v=8BJfMPxQuiU
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04:51 AM on 11/02/2010
I'm not a Franklin scholar, but one of the problem with our society is that many of our public services such as health care or prisons are being run "for profit". Their aim is not of increasing public health or safety but increasing throughput and generating fees. These entities have become constituencies which lobby the government for more and more business.
Meanwhile in America today, there are more people than there are jobs with decent wages to employ them. But the emphasis of our tax and regulatory structure encourages employers to seek out the lowest cost labor (overseas) or eliminate it entirely.
01:29 PM on 11/02/2010
Combine everything you've said with this. The hassle factor for opening new small businesses is very, very, very high. A handy fellow suddenly unemployed can't go pick up his tool belt and start doing plumbing work. The bureaucracy to opening a business is never talked about and amazingly onerous. That needs to be fixed too.
01:13 AM on 11/02/2010
Since you like Franklin.
'When the people find they can vote themselves money,
that will herald the end of the republic."
04:08 AM on 11/02/2010
yes the lame ass voters of both sides have gotten fat and rich on the treasury.. Time to change that. and for Pain for the voter.
Tough shit.
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thereisonlyoneparty
more amazing than you
10:27 AM on 11/02/2010
Every election is based on what the guy or, god forbid, woman will provide for "me" if I vote for them.

Whoever promises me the most "free" stuff (and it is free, the future has already said it will foot the bill) is the one that gets "my" vote. Election days are like Christmas and Hanukkah rolled into one glorious day of consumption.
10:40 AM on 11/02/2010
They have found that they can vote themselves money,their called lobbyist,get rid of them!
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HUFFPOST SUPER USER
DustyMills
A liberal tree-hugging Oregonian...
12:35 AM on 11/02/2010
This article is both sobering & insightful.....the fact that there are people in this country who lay down in their warm beds at night, their stomach full and who have the means to seek medical help if they need it, are without a thought that there are many who don't have these simple needs, is unconscionable. This is the way of the conservative republicans.....they feel more strongly about having to pay taxes than whether or not a child is going hungry.

The social values this country was built on is what made this nation great, it is our feelings for our fellow man that distinguishes us from those countries that allow all kind of horror upon it's people.

The republicans may gain a majority after tomorrows election due to the anger many feel toward the economy that GWBush left us, but I don't believe it will last for long. The majority of this country's population believe in social justice and the health & freedom that comes with it.....something the republicans have never offered this country.
04:10 AM on 11/02/2010
Yes.. this is all George Walker Bush's fault.

Or it could be your insanity.

Not sure yet.
09:47 AM on 11/02/2010
You can afford your meds. you should take them then.
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HUFFPOST SUPER USER
Miriam Breslauer
11:06 AM on 11/02/2010
Even those with the means to afford medical care in the US are getting poor quality for their dollars. It is a myth that we have one of the best medical systems in the world if you can just pay for it. I know Millionairres who can't get proper care for orphaned genetic disorders that they have, because the condition is considered "too rare" for anyone to have. So those people are sent to psych wards until they get "better" and stop complaining about needing care.
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HUFFPOST SUPER USER
whyus
San Francisco native
11:20 PM on 11/01/2010
The rich should pay higher taxes, corporations should not be allowed to off-shore, and we could start putting $$ back into the system. Unfortunately, the rich and the corporations have many lawyers to get them off paying their "fair share".
01:33 PM on 11/02/2010
How exactly are you going to prevent a company from offshoring? How does that work? Are you so disconnected as to actually believe that the multinationals can even be touched?

The company I work for, if fedgov does something stupid could within 48 hours simply re route all operations to Singapore. Including upper management. Closing down the US facilities would take a month. Bam. You do not understand the reality.